LESLEY NICOLOFF OTTO MD, LLC; NPI #1417138769

Contact Information

LESLEY NICOLOFF OTTO MD, LLC

9155 SW BARNES RD
SUITE 634
PORTLAND, OR 97225-6633

Phone: 503-297-4123
Fax: 503-297-0344
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Gynecology	207VG0400X	16	Physician/Obstetrics & Gynecology

Indicates primary specialty

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NPI Profile & details for LESLEY NICOLOFF OTTO MD, LLC

NPI # 1417138769

LBN Legal business name LESLEY NICOLOFF OTTO MD, LLC

Authorized official LESLEY OTTO - (PHYSICIAN)

Entity Organization

Organization subpart ¹ No

Enumeration date 11/15/2007

Last updated 12/20/2010 - About 15 years ago

Identifiers

OR	License #	MD18878
OR	Medicaid	073122
OR	Other	MD18878	MEDICAL LICENSE

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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